PROJECT SUMMARY/ABSTRACT ? OVERALL The Duke Comprehensive Cancer Center was founded as a matrix center within the Duke University School of Medicine in 1972 and the Duke Cancer Institute (DCI) was created as a new administrative entity within Duke Health in October 2010, with authority and responsibility for all cancer-related activities at Duke University and in the Duke University Health System. The DCI was started with significant investments from Duke Health, including a new $243M clinical care outpatient facility, over $60 million of new funds available to support new initiatives, and a commitment for ongoing annual investment by the Duke Health System. DCI faculty include well-established and funded experts spanning the full spectrum of cancer research fields, from intracellular signaling to cancer genomics to therapeutic development and testing to population science. DCI programmatic activities support the career development of the next generation of cancer experts and provide platforms for multi-disciplinary scientific teams to develop and test new hypotheses. During the most recent funding period, the DCI structure has continued to evolve and mature, currently consisting of 304 members from 34 departments within 7 schools at Duke University (Medicine, Nursing, Arts and Sciences, Engineering, Public Policy, Environment, and Business) and organized as 8 multi-disciplinary research programs (2 basic discovery, 1 population science, and 5 translational/clinical) whose work is supported by 14 Shared Resources (8 lab-based and 6 supporting translational/clinical/population research activities). In addition to Program and Shared Resource leaders, DCI senior leadership, which includes an Executive Director, Deputy Director, 7 Associate Directors, and 8 other key leaders, provides oversight and direction of DCI initiatives. DCI members are currently supported by over $111M of external cancer-related grant support (direct costs), over $63M of which is peer- reviewed, including 32 peer-reviewed, multi-investigator grants (involving 81 subprojects/cores) and 61 training and fellowship awards. DCI members published over 5,750 cancer-focused papers during the past funding period, ~40% of which represent collaborative efforts between DCI investigators. On average, ~7,000 new cancer patients are seen each year at the Duke University Hospital. In 2018, DCI Programs enrolled over 4,000 patients on clinical trials, including nearly 2,000 interventional accruals and 770 therapeutic accruals. DCI is heavily engaged in both community outreach/engagement and educating the next generation of cancer clinicians and scientists. Duke Health support of the DCI included a total of over $65M of additional investment in the most recent funding period, including support for recruitment, retention, and protected academic time for DCI faculty. The DCI completed an extensive 5-year Strategic Planning process, identifying strategic goals and priorities that enable the DCI mission to ?Discover, Develop, and Deliver the future of cancer care?now?, resulting in a series of discrete recommendations that are serving as a guide for determining current and future resource allocation, recruiting priorities, and infrastructure changes required to achieve DCI goals.